| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $200 | $202 | $203 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $242 | $244 | $246 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $77 | $131 | $158 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $140 | $197 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $81 | $138 | $166 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $78 | $117 | $184 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $133 | $179 | $203 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $142 | $245 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $131 | $201 | $272 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $107 | $167 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $155 | $237 | $320 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $112 | $177 | $242 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $276 | $400 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $329 | $329 | $329 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $129 | $179 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $74 | $106 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $23 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $74 | $165 | $255 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $98 | $178 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $63 | $134 | $211 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $89 | $90 | $92 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $107 | $115 | $122 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $58 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $44 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $54 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $73 | $134 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $6 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $494 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $3,289 | $6,054 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $110 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $1,718 | $2,281 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $194 | $215 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $770 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $467 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $226 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $305 | $357 | $461 |
| Septoplasty CPT 30520 • ENT | $697 | $874 | $1,051 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $230 | $232 | $234 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $148 | $172 | $197 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $259 | $260 | $262 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $325 | $389 | $453 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $252 | $286 | $321 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $217 | $295 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $206 | $234 | $262 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $294 | $334 | $374 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $157 | $192 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $224 | $254 | $283 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $296 | $394 | $491 |